Abstract
Designing and Implementing an Evaluation to Capture Health Equity Program Implementation: A Multi-Component Approach
Aisha Tucker-Brown, PhD, MSW1, Rachel Davis, MPH2, Gia Rutledge, MPH3 and Iris (Joi) Hudson, MPH4
(1)Centers for Disease Contril and Prevention, Atlanta, GA, (2)Centers for Disease Control and Prevention, Atlanta, GA, (3)CDC, Atlanta, GA, (4)Centers Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity, Atlanta, GA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
To support healthier behaviors and improve chronic conditions, the Centers for Disease Control and Prevention emphasizes coordination of chronic disease prevention and health promotion within health departments. CDC funded state and local health departments through two complementary programs to control and prevent obesity, diabetes, heart disease, and stroke among general and priority populations. State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health (SPHA-1305) was designed to support statewide implementation of strategies that promote chronic disease prevention. State and Local Public Health Actions to Prevent Obesity, Diabetes and Heart Disease and Stroke (SLPHA-1422) was developed to further promote the work of SPHA-1305 and emphasize health equity. SLPHA-1422 promoted the implementation of mutually reinforcing strategies and an approach intended to improve outcomes for both the general and priority populations (the dual approach). The programs were evaluated with a focus on understanding how health departments were implementing evidence-based interventions, including the dual approach and mutually reinforcing strategies; assessing changes in health behavior, environmental, and system-level outcomes; and identifying promising strategies for increasing reach and improving outcomes among priority populations in an effort to improve health equity. This session will describe the evaluation approach and how quantitative and qualitative data from primary and secondary data sources were used to assess the extent to which the implementation of mutually reinforcing strategies and the dual approach has helped to control and prevent chronic disease among general and priority populations. Data captured from 2013-2018 will be discussed throughout the presentation.
Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Implementation of health education strategies, interventions and programs Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Results from the Field: The Impact of a Health Equity Focus to Effect Change in Heart Disease and Stroke Prevention
Rachel Davis, MPH1, Aisha Tucker-Brown, PhD, MSW2, Jasmin Minaya Junca, MPH1, Julia Jordan, MPH1, Tiffany L Burgess, MPH3, Kincaid Lowe Beasley, MPH1 and Cagney Stigger, MPH
(1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Centers for Disease Contril and Prevention, Atlanta, GA, (3)ICF, Atlanta, GA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Heart disease remains the leading cause of death in the U.S. Cardiovascular Disease, including heart disease, stroke, and other vascular diseases, accounts for more than 840,000, or about 1 in 3, deaths per year. CDC’s Division for Heart Disease and Stroke Prevention has focused on the improvement of health care systems and linkages with community resources in the general and priority populations through the implementation of two funded programs (SPHA-1305 and SLPHA-1422). Evaluations of both programs have shown increases in the implementation of evidence-based strategies to prevent and control hypertension, including 1) the promotion of a team based care approach and 2) the engagement of community health workers (CHWs) to link patients with hypertension to community resources both of which are proven strategies for working with vulnerable populations. Evaluation findings also highlight improvements in key health outcomes for the general and priority populations with a focus on health equity. This presentation will provide both qualitative and quantitative examples that demonstrate how implementation of evidence-based practices at the state and local levels contributed to improvements in health outcomes and progress in closing the gap on health equity. Examples of outcomes achieved through 2017 include:
• 63% of adults with known high blood pressure have achieved blood pressure control (increase of 6% from baseline),
• 63% of health care systems have policies promoting multidisciplinary team care (increase of 11% from baseline),
• 108 health care systems engage CHWs to link patients to resources to promote self-management of high blood pressure (increase of 130% from baseline).
Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice Social and behavioral sciences
Abstract
Evaluation Results and Impact of Strategies to Build Support for Healthy Lifestyles and Community Clinical Linkages to Support Diabetes Prevention Efforts Particularly for Vulnerable Populations
Gia Rutledge, MPH1, Meenu Anand, MPH, Yvonne Mensa Wilmot3, Kimberly Farris, PhD, MPH, MSW4, Shelly-Ann Bowen, PhD, MS, CT(ASCP)5, Sharanya Thummalapally, MPH5, Monica Murphy, MPH5 and Timethia Bonner
(1)CDC, Atlanta, GA, (2)Centers for Disease Control and Prevention, Atlanta, GA, (3)CDC,, Atlanta, GA, (4)ICF, Atlanta, GA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
The National Diabetes Prevention Program (National DPP) includes a yearlong structured lifestyle change program (in person or online) developed specifically to prevent or delay type 2 diabetes. The Division of Diabetes Translation is committed to increasing enrollment and retention in the program, particularly among priority populations. In SLPHA-1422, states, large cities, and sub-awardees worked to scale and sustain the National DPP by working through network partners, implementing evidence-based engagement strategies, and increasing coverage and referral policies.
Qualitative and quantitative data were extracted and analyzed from the states’ annual performance reports to examine the grantee activities implemented to scale and sustain the National DPP. Performance measure data were analyzed from baseline to year 4 to determine year-to-year percent change. In addition, qualitative data from the states’ year 2 evaluation reports were analyzed to identify states’ barriers and facilitators to implementing activities, as well as how barriers were overcome.
Analysis of 21 grantees’ performance measure data shows an increase from baseline to year 3 in the number of people with prediabetes or at high risk for type 2 diabetes enrolled in the CDC-recognized lifestyle change program. Findings of this evaluation, from baseline to the final year of implementation, will be provided among all populations as well as priority populations, specifically highlighting quantitative and qualitative results of efforts to scale and sustain the National DPP. Recognizing that barriers to program implementation among priority populations exist, it is imperative that implementation approaches be evaluated and lessons learned be shared with grantees and national partners.
Chronic disease management and prevention Diversity and culture Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Impact of Applying a Health Equity Approach to Nutrition and Physical Activity Strategies in the Centers for Disease Control and Prevention State and Local Public Health Actions (SLPHA-1422) Program
Iris (Joi) Hudson, MPH
Centers Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity, Atlanta, GA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Obesity and related risk factors - physical inactivity and poor diet - are major public health problems in the U.S. Substantial disparities exist among some priority populations (i.e. those with high burden of chronic disease, or those experiencing health inequities and disparities). The Centers for Disease Control and Prevention’s (CDC) State and Local Public Health Actions program (SLPHA-1422) was designed to reduce health disparities and improve health equity by addressing obesity and its related risk factors among U.S adults. The CDC’s Division of Nutrition, Physical Activity and Obesity recommended four evidence-based strategies in SLPHA-1422 aimed at increasing access to healthier foods and safe and accessible places to be physically active to support obesity prevention.
One component of the SLPHA-1422 evaluation measured impact of implementing these strategies through review and analysis of the following data: 1) performance measure data; 2) state and local evaluation reports; and 3) other awardee reporting documents. The impact of implementing the four strategies across 21 SLPHA-1422 awardees includes: 9.1 million more adults have access to retail venues and community venues that promote healthier food, and 3.4 million more adults have access to community venues that promote physical activity. Impacted adults include those of low socioeconomic status, high chronic disease burden, or diverse racial/ethnic backgrounds, etc. SLPHA-1422 demonstrated successful implementation of strategies at the state and local level. Increased access to healthier foods and safe and accessible places to be physically active result in healthier environments that address chronic disease health inequities and disparities experienced by priority populations.
Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health